A rare case of a concomitant inguinal and obturator hernia and their laparoscopic transabdominal repair: A case report

Abstract

An obturator hernia remains a rare occurrence and accounts for less than 1% of all abdominal wall hernias. To have a concomitant presentation with a direct inguinal hernia makes this an extremely rare case report. This patient did not fit the usual epidemiological profile of an elderly female with small intestinal obstruction. This was a male patient with an asymptomatic obturator hernia. There are no concise guidelines for obturator hernia management and the primary repair is often undertaken in the presence of bowel incarceration or strangulation. The use of overlapping mesh herniorrhaphy is a controversial one. Two self-gripping polypropylene meshes with a 2-cm overlap were used to provide adequate coverage of the two hernial necks. We did not have access to a large-size mesh at our institution to cover both hernial defects effectively with one mesh. The patient made an uneventful recovery, and it is our intent to follow this patient for a minimum of 2 years to document any hernia recurrence or inguinodynia. Any clinical signs of pain or discomfort will necessitate a computerised tomography scan as an obturator hernia remains difficult to assess clinically.